Establishing the contribution of nursing in the community to the health of the people of Scotland: integrative literature review

Abstract

This paper is a report of an integrative literature review to explore the evidence base for nursing in the community. The Scottish Executive (2005) in Scotland (UK), announced that a review of nursing in the community should be undertaken to inform implementation of the policy Delivering for Health. This policy called for a fundamental shift in the focus of care away from acute hospitals into the community where health care in the future will be concentrated. To inform this review of nursing in the community, the Scottish Executive commissioned a literature review. An integrative literature review was carried out during 2006 (February to April). We carried out an extensive literature search using multiple electronic databases and hand-searched key texts to find suitable systematic reviews and primary quantitative and qualitative papers for review (1996-March 2006). We included English language publications describing systematic reviews and primary empirical research about community nurses' contributions to the health of people. Seventy-three papers (12 systematic reviews and 61 studies) met our inclusion criteria. All of the studies were scored as either 'low' or 'medium' quality. None merited a 'high' quality rating. There is little research evaluating the impact of community nursing actions. Adequately resourced research is needed to strengthen the evidence base to support nurses in the community in delivering effective and efficient care that meet the health needs of people and communities.